Arthrogryposis multiplex congenita: an autopsy case of a fatal form

A case of a severe and fatal form of arthrogryposis multiplex congenita with a full necropsy examination is presented in which the central nervous system and many muscles of the four extremities were examined histologically. The most striking feature was a great reduction in the muscular tissue of the limbs with a marked increase in the adipose tissue. The muscular changes were thought to be caused by neurogenic atrophy, and microscopy of the spinal cord revealed developmental abnormalities, including degenerative changes of the anterior horn cells. Neonatal and fatal cases of arthrogryposis multiplex congenita reported in the literature are briefly reviewed, and the characteristics of the present case and its relation to other congenital neuromuscular disorders are discussed.

A new familial arthrogryposis without weakness

A father and two daughters have a distinctive form of arthrogryposis multiplex congenita in which there is neither weakness nor atrophy about the affected joints despite the existence of myopathy. Contractures of the hips arid shoulders are present in all three individuals, but only the father has severe involvement of the hands and feet. Serum creatine phosphokinase values are 1.5 and three times normal in the daughters and five times normal in the father. Although it is likely that the myopathy and arthrogryposis are due to the effects of a dominantly inherited gene that appears as a new mutation in the father, the mechanism of production of the arthrogryposis in the absence of weakness is unknown.

Arthrogryposis following treatment of maternal tetanus with muscle relaxants

Images